Background: It is uncertain whether biomarkers differ in singleton pregnant women with metabolic dysfunction-associated fatty liver disease (MAFLD) and gestational diabetes mellitus (GDM).

Methods: A prospective cohort study was conducted. A FibroScan® was performed between 10-24 weeks. A controlled attenuation parameter score ≥233.5dB/m indicated MAFLD. GDM was diagnosed with IADPSG criteria. Between 24-30 weeks, fasting blood was collected to determine serum levels of tumour necrosis factor alpha (TNF-α), interleukin 6 (IL-6), fibroblast growth factor 21 (FGF-21), high molecular weight adiponectin (HMW-APN), glucose and insulin. HOMA-IR was calculated: [insulin (mU/L) × glucose (mmol/L)]/22.5. Four groups of control (no GDM/MAFLD), MAFLD only, GDM only, MAFLD & GDM were formed. Biomarkers were analyzed by general linear models after log transformation, adjusted for age, body mass index, ethnicity and nulliparity.

Results: Of 120 women, 47 were control, 37 MAFLD only, 14 GDM only and 22 MAFLD & GDM. Compared to controls, MAFLD & GDM had 1.8-fold higher HOMA-IR and IL-6, significantly elevated over GDM only and MAFLD only (Table 1). No significant differences in TNF-α, FGF-21 or HMW-APN occurred (Table 1).

Conclusions: Significantly elevated HOMA-IR and IL-6 in pregnant women with MAFLD & GDM suggests a more insulin resistant and inflammatory phenotype.

Disclosure

T.Y.L.Chai: None. D.Pasupathy: None. J.George: None. N.Cheung: None.

Funding

Diabetes Australia Research Program (Y21GCHEW)

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